NR 667 VISE PRACTICE TEST 2025/2026 ACCURATE QUESTIONS WITH CORRECT DETAILED ANSWERS || 100% GUARANTEED PASS <RECENT VERSION>

NR 667 VISE PRACTICE TEST 2025/2026 ACCURATE QUESTIONS WITH CORRECT DETAILED ANSWERS || 100% GUARANTEED PASS &lt;RECENT VERSION&gt; 1. Reflux esophagitis assessment findings - ANSWER heartburn, burning beneath sternum, postprandial and nocturnal regurgitation, chest/neck pain, chronic cough, lump in throat, post nasal drip, erosion of teeth from acid 2. Reflux PE assessment - ANSWER Heart, lungs GI Epigastric tenderness HEENT- mouth/oropharynx 3. Reflux diagnosis - ANSWER based on history (primary) and PE Empiric PPI for 8 weeks Endoscopy after 8 week trial and unresolved 4. Reflux non-pharm - ANSWER Removing or modifying risk factors like coffee, spicy food, chocolate, and citrus. Small, frequent meals Sit up 2 hours after meals Elevate head of bed, lay on left side 5. Reflux pharm - ANSWER Omeprazole 20mg daily before breakfast for 8 weeks 6. Reflux f/u - ANSWER Return 4-8 weeks for effectiveness GI referral after 8 weeks without resolution 7. Reflux differentials - ANSWER H. Pylori infection PUD Asthma 8. Acute laryngopharyngitis presentation (Strep) - ANSWER sore throat, tonsillar exudate, cervical adenopathy, fever, no cough, petechiae on soft palate, beefy red tonsils, sandpaper rash 9. Acute laryngopharyngitis presentation (Virus) - ANSWER fever, cough, nasal congestion, hoarseness, diarrhea, viral rash 10. Acute laryngopharyngitis diagnosis - ANSWER rapid strep test 11. Acute laryngopharyngitis non pharm - ANSWER gargle with warm salt water, increase fluids, change toothbrush 48-72 hours after abx 12. Acute laryngopharyngitis pharm - ANSWER Pen V K 500 mg PO BID x 10 days Cephalexin 500mg PO BID x 10 days if PCN allergy No f/u unless worsening symptoms 13. Allergic Rhinitis Presentation - ANSWER clear nasal discharge, pale nasal mucosa, red and watery eyes along with nasal congestion, rhinorrhea, itching of nose, eyes, palate, sneezing, cough 14. Allergic Rhinitis PE Assessmnet - ANSWER Assess for conditions such as asthma, atopic dermatitis, sleep disordered breathing, conjunctivitis, otitis media Dark discolored area beneath lower eyelids transverse crease on tip of nose enlarged tonsils and adenoids 15. Allergic Rhinitis testing - ANSWER Specific IgE testing (blood or skin) should be performed for patients with a clinical diagnosis of AR who do not respond to empiric treatment, or when diagnosis is uncertain, or when determination of specific target allergen is needed. (allergy panel) 16. Allergic Rhinitis non pharm - ANSWER avoid triggers such as allergens or environmental 17. Allergic Rhinitis pharm - ANSWER Intranasal steroids (Budesonide or Fluticasone) should be prescribed for patients whose symptoms affect quality of life or Oral second-generation/less sedating antihistamines (Cetirizine or Loratadine) should be prescribed for patients with AR and primary complaints of sneezing and itching or Intranasal antihistamines may be prescribed for patients with seasonal, perennial, or episodic AR. 18. Allergic Rhinitis follow-up - ANSWER F/U 5-7 days after mono therapy, switch to another first line monotherapy if first failed Referral to ENT needed if symptoms persist or worsen 19. UTI Presentation - ANSWER Urgency, dysuria, increased frequency, incomplete bladder emptying, fever, chills, hematuria, lower abdominal pain/flank pain, dribbling of urine in men, foul smelling urine, small volume/ frequent voiding 20. UTI diagnosis - ANSWER UA- WBC positive, Nitrate positive, urine culture Pyridium can cause false positive May also collect STI test, C&S After 2-3 days, WBC &gt;100,000 21. UTI older adult symptoms - ANSWER New onset of confusion fatigue 22. UTI differentials - ANSWER Overactive bladder, Vaginitis, STI, PID, prostatitis, BPH UTI pharm - ANSWER E.Coli most common cause Macrobid 100mg BID x 5-7 days Keflex 500mg PO BID-TID 3-5 days 23. UTI non pharm/preventative - ANSWER voiding after sexual intercourse, practice genital hygiene, loose fitting clothing, improve glucose levels in diabetic 24. 8. Asthma PE findings - ANSWER exp wheezing, SOB, non productive cough, tachypnea, tachycardia, accessory muscle use, sudden nocturnal dyspnea, decreased exercise tolerance, chest tightness 25. Asthma diagnostics - ANSWER PFT spirometry, peak flow monitoring 26. Asthma Non pharm - ANSWER avoid allergens and irritants, educate S/S of exacerbation, asthma action plan, immunizations UTD 27. Asthma Pharm reliever - ANSWER All need PRN reliever- ICS- Formoterol (Symbicort) ICS-SABA SABA (albuterol) 28. Asthma Pharm step 1-2 - ANSWER low-dose ICS plus formoterol (ICS formoterol) and a SABA as needed. Example: Budesonide/Formoterol — MDI† 80 mcg/4.5 mcg or 160 mcg/4.5 mcg2 puffs 2x/day; dose depends on the level of severity or control. 29. Asthma Pharm step 3 - ANSWER low-dose ICS + either LABA, LTRA, or theophylline(b) OR medium-dose ICS Example: budesonide/formoterol inhaled, Singulair (LTRA) 30. Asthma pharm step 4 - ANSWER Severely uncontrolled asthma or with an acute exacerbation medium-dose ICS + LABA 31. Asthma Education - ANSWER Use of inhalers Avoid triggers smoking cessation Children- avoid ASA (Reyes syndrome) 32. Asthma F/U - ANSWER Every 2-6 weeks while gaining control Every 1-6 months to monitor control Every 3 months, if step down in therapy is anticipated Refer to pulmonologist for severe asthma received over 2 rounds of oral steroids/ year 33. Asthma differentials - ANSWER URI COPD CHF GERD CF PE 34. 9. HTN presentation - ANSWER Typically asymptomatic Some patients may present with occipital headaches, headache on awakening in AM, blurry vision, posterior neck pain, and dizziness 35. HTN Findings for organ damage - ANSWER rule out organ damage: Microvascular Eyes- AV nicking, flame shaped hemorrhage, silver/copper wire arterioles. Kidneys- microalbumin and proteinuria, elevated serum cr, abnormal eGFR, peripheral/generalized edema Macrovascular Heart- S3 (CHF), S4 (LVH), carotid bruits, CAD, acute MI, decreased/absent pedal pulse Brain- TIAs, hemorrhagic stroke 36. HTN Assessment PE - ANSWER treat for BP &gt;140/90 HEENT- blurry vision, optic fundi look for AV nicking, hemorrhage, papilledema Cardio- heart sounds, perform symmetrical pulses Lungs- SOB, pulmonary edema Neuro- occipital headache, headache upon awakening, dizziness Auscultate for carotid bruits bilaterally, abdominal bruits, and kidney bruits 37. HTN Diagnostics - ANSWER CBC, CMP, UA TSH, Lipid, fasting glucose EKG, CXR 38. HTN non pharm - ANSWER Lifestyle modification: weight loss, smoking/alcohol cessation, healthy diet, and sodium reduction Maintain BP log 2x/ daily and bring to next f/u 39. HTN pharm - ANSWER Diuretics: Hydrochlorothiazide (HCTZ) 25mg/day max 50mg/day) *May worsen gout and elevate lipids and glucose. Preferred in patient with osteoporosis and African Americans.  Ace inhibitors (-PRIL): Complicated HTN, renal/cardio protective for DM patients. (Lisinopril 10mg/day) *Hyperkalemia risk. If patient develops angioedema transition to ARBs  ARB's (-SARTAN): Renal/cardio protective for DM patients. (Losartan 25mg/day) *Hyperkalemia risk.  CCB's (-PINE): Preferred in African American and patient &gt;65 years old with (with stiff artery). (Amlodipine besylate 5mg/day) *Watch for lower extremity edema and avoid in GERD patients (weakens gastric sphincter).  Consider ACE/ARB in patients with DM, proteinuria, HF. (ACE/ARB contraindicated in pregnancy).  If stage 2 HTN, initiate 2 drug classes (Diuretics and CCB).  BP meds safe for pregnancy: Nifedipine, Labetalol, and Methyldopa 40. HTN F/U - ANSWER Reassess in 1 month for effectiveness of BP lowering medication therapy. If goal is met at 1 month, reassess in 3 to 6 months. If goal is not met after 1 month, consider different medication or titration 41. 10. Hyperlipidemia history - ANSWER familial hypercholesterolemia, diet, exercise habits, tobacco, alcohol, or drug use, symptoms of peripheral arterial disease, angina, stroke, or presence of coronary artery disease 42. Hyperlipidemia PE - ANSWER BP, carotid/abdominal bruits, assess skin for xanthomas, listen for S4 sound, palpate all 4 extremities for intact peripheral pulses. 43. Hyperlipidemia differentials - ANSWER DMII, hypothyroid, metabolic syndrome 44. Hyperlipidemia labs - ANSWER A1C/ fasting glucose TSH Lipid panel